Rank: Guest
Joined: 9/8/2012(UTC)
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Hi all,
Provider gave me a bill to submit to insurances with D8090 for full orthodontic treatment.
I found the cross code on this forum, CPT code 41899.
In order to submit to medical insurance do I need to get the provider to use the CPT code on their official paperwork? Has anyone had any experience trying to get a provider to use medical codes instead of dental codes?
Thanks for your help, and for all of the useful information here!
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi Guest!
Great question. Yes we work with thousands of dental practices who utilize ICD & CPT/HCPCS coding to bill a patient's medical insurance for medically necessary procedures performed in the dental practice setting. It is not something the large majority of dental practices are currently familiar with, but we train them to do so through our continuing education seminars and our software!
However, as it looks like you found - not every CDT code (dental code or "D" codes) has a direct crosscode into the medical coding system (CPT & HCPCS). Also, some medical insurers will actually process the "D" code on the medical claim when there is not a CPT/HCPCS crosscode available. If the insurer does not process "D" codes in their system and there is not a CPT crosscode available, you use an "unspecified" or "unlisted" or "by report" code, such as 41899.
As far as orthodontics and medical insurance - of course that is not something typically covered by medical insurance if it is for mainly cosmetic purposes. However, we have seen coverage of orthodontic services when needed due to a traumatic accident, for example, or for a child with a severe handicapping malocclusion.
Hope this helps!
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